An in vivo monitoring method in a laparoscope system is provided. An object image is sequentially created with expression of a surface color of an object in a body cavity. A lock area (specific area) is determined within the object image, the lock area being movable by following motion of the object. A monitor image including a graph of oxygen saturation is generated according to a part image included in the object image and located in the lock area. The monitor image is displayed. Preferably, the oxygen saturation of the lock area is acquired according to two spectral data with respect to wavelengths of which an absorption coefficient is different between oxidized hemoglobin and reduced hemoglobin in data of the object image. The object is constituted by a blood vessel.
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15. An in vivo monitoring method comprising steps of:
creating an object image with information of oxygen saturation of a blood vessel;
determining a lock area within said object image;
updating a location of said lock area according to motion of said object at each time of creating a frame of said object image, said updating step executing:
extracting first landmark points from a first frame, and to extract second landmark points from a second frame created after creation of said first image, wherein said first and second landmark points are distinct from said lock area;
specifying part of said second landmark points whose feature value is equal to part of said first landmark points;
obtaining a movement amount between said first and second landmark points whose feature value is equal; and
changing the location of said lock area according to said movement amount;
acquiring said oxygen saturation in said lock area when said lock area is updated;
generating a monitor image including acquired change information of said oxygen saturation; and
displaying said monitor image.
1. A tissue imaging system comprising:
an imaging unit configured to create an object image with information of oxygen saturation of a blood vessel;
an area determining unit configured to determine a lock area within said object image;
a location updating unit configured to update a location of said lock area according to motion of said object at each time of creating a frame of said object image, said location updating unit executing:
a landmark point extracting process to extract first landmark points from a first frame, and to extract second landmark points from a second frame created after creation of said first image, wherein said first and second landmark points are distinct from said lock area;
a landmark point specifying process to specify part of said second landmark points whose feature value is equal to part of said first landmark points;
a movement amount obtaining process to obtain a movement amount between said first and second landmark points whose feature value is equal; and
a location changing process to change the location of said lock area according to said movement amount;
a data acquisition unit configured to acquire said oxygen saturation in said lock area when said lock area is updated;
a monitor image generating unit configured to generate a monitor image including acquired change information of said oxygen saturation; and
a display unit configured to display said monitor image.
2. A tissue imaging system as defined in
3. A tissue imaging system as defined in
4. A tissue imaging system as defined in
5. A tissue imaging system as defined in
6. A tissue imaging system as defined in
7. A tissue imaging system as defined in
wherein said imaging unit is a color image sensor for imaging said object illuminated with said narrow band light and said broad band light.
8. A tissue imaging system as defined in
9. A tissue imaging system as defined in
a ratio generator configured to determine a first signal ratio of a blue signal of said special light mode image to a green signal of said normal image, and a second signal ratio of a red signal of said normal image to a green signal of said normal image;
a correlation memory configured to store information of a correlation between said oxygen saturation and said first and second signal ratios; and
an arithmetic processor configured to determine said oxygen saturation in said lock area by use of said correlation read from said correlation memory and said first and second signal ratios obtained by said ratio generator.
10. A tissue imaging system as defined in
wherein said imaging unit is a monochromatic image sensor for imaging said object illuminated with said narrow band light components.
11. A tissue imaging system as defined in
12. A tissue imaging system as defined in
a ratio generator configured to determine a first signal ratio of said blue signal to said green signal, and a second signal ratio of said red signal to said green signal;
a correlation memory configured to store information of a correlation between said oxygen saturation and said first and second signal ratios; and
an arithmetic processor configured to determine said oxygen saturation in said lock area by use of said correlation read from said correlation memory and said first and second signal ratios obtained by said ratio generator.
13. A tissue imaging system as defined in
14. A tissue imaging system as defined in
16. An in vivo monitoring method as defined in
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1. Field of the Invention
The present invention relates to a tissue imaging system and in vivo monitoring method. More particularly, the present invention relates to a tissue imaging system and in vivo monitoring method in which oxygen saturation of body tissue in a body cavity is monitored with high stability even upon incidental shift of a field of view of an imaging instrument for imaging of by body tissue.
2. Description Related to the Prior Art
JP-A 2000-139947 discloses percutaneous treatment (laparoscopic surgery) of a patient's body by use of a laparoscope. In the percutaneous treatment, two or three holes are formed in skin outside an abdominal cavity. The laparoscope and a medical instrument for operation are inserted in the holes into the abdominal cavity. The abdominal cavity is insufflated with gas, such as carbon dioxide gas. A doctor or operator observes an image in the abdominal cavity by use of a monitor display panel, and carries out the percutaneous treatment by use of the medical instrument. The percutaneous treatment is characterized in that the view of field of imaging in the laparoscope is limited considerably, so that the doctor or operator must have a high technical skill. There is an advantage in the percutaneous treatment in that physical stress to the patient is very low, because it is unnecessary to incise the abdominal cavity surgically.
A low oxygen environment is likely to occur with blood vessels in the abdominal cavity because carbon dioxide gas is used in the percutaneous treatment for insufflating the abdominal cavity. In case of the low oxygen environment, the percutaneous treatment is interrupted to start surgical operation. It is necessary in the percutaneous treatment to monitor an oxygen saturation in blood of the blood vessels.
Various methods of monitoring the oxygen saturation are known. In a first one of the methods, a measurement probe is held manually with fingers of a doctor or operator, and measures the oxygen saturation percutaneously. A second one of the methods is disclosed in a relevant website, http://www.spectros.com/products/t-stat-ischemia-detection/about-t-stat/system-overview.html (found on 12 Nov. 2010) in which a non-contact measurement probe is advanced through an instrument channel in the laparoscope, and measures the oxygen saturation of the blood vessels in a non-contact manner. The non-contact measurement probe applies measuring light of a predetermined wavelength to the blood vessels, and receives the light reflected by the blood vessels by use of a CCD image sensor or the like. The image sensor generates an image signal according to which the oxygen saturation of the blood vessels is determined.
Specifically in an artery bypass operation in the percutaneous treatment, it is possible in the non-contact measurement probe of the above-indicated relevant website to monitor changes in the oxygen saturation with time of the blood vessels important surgically (for example, aorta and coronary artery), for the purpose of safety in the percutaneous treatment. However, the above-indicated relevant website discloses measurement in a protruding state of the non-contact measurement probe from a tip of the laparoscope. Should motion occur with the tip of the laparoscope incidentally or in the course of the treatment, there occurs a shift in the position of the non-contact measurement probe. Measuring light from the non-contact measurement probe cannot be sufficiently applied to the blood vessels to be monitored upon occurrence of the shift of the non-contact measurement probe. The oxygen saturation of the blood vessels cannot be exactly determined due to the incidental shift of the non-contact measurement probe.
In view of the foregoing problems, an object of the present invention is to provide a tissue imaging system and in vivo monitoring method in which oxygen saturation of body tissue in a body cavity is monitored with high stability even upon incidental shift of a field of view of an imaging instrument for imaging of by body tissue.
In order to achieve the above and other objects and advantages of this invention, a tissue imaging system includes an imaging unit for creating an object image of an object with information of oxygen saturation of a blood vessel. An area determining unit determines a specific area within the object image, the specific area being movable by following motion of the object. A monitor image generating unit generates a monitor image including change information of the oxygen saturation according to a part image included in the object image and located in the specific area. A display unit displays the monitor image.
Furthermore, a location updating unit updates a location of the specific area according to the motion of the object at each time of creating a frame of the object image. A data acquisition unit acquires the oxygen saturation of the part image in the specific area when the specific area is updated. The monitor image generating unit generates a graph of the oxygen saturation changeable with time, and the monitor image includes the graph.
The location updating unit extracts a landmark point in relation to the object at each time of creating a frame of the object image, and updates the location of the specific area according to the landmark point.
The object is constituted by a blood vessel, and the landmark point is extracted from a form of the blood vessel.
The location updating unit determines a shift between plural frames of the object image created with a time difference, and updates the location of the specific area according to the shift.
The object image created by the imaging unit is two spectral images of wavelength components of light of which an absorption coefficient is different between oxidized hemoglobin and reduced hemoglobin, and the data acquisition unit acquires the oxygen saturation of the specific area according to the two spectral images.
The display unit displays a currently created frame of the object image within the monitor image together with the graph.
Furthermore, an alarm device generates an alarm signal if the oxygen saturation in the specific area becomes equal to or lower than a predetermined level.
Furthermore, an illumination apparatus applies narrow band light of a predetermined wavelength range and broad band light of a broad wavelength range alternately to the object. The imaging unit is a color image sensor for imaging the object illuminated with the narrow band light and the broad band light.
In another preferred embodiment, furthermore, an illumination apparatus applies plural narrow band light components of wavelength ranges different from one another to the object successively one after another. The imaging unit is a monochromatic image sensor for imaging the object illuminated with the narrow band light components.
The object is present in an abdominal cavity, and the imaging unit is a laparoscope.
In another preferred embodiment, the object is present in a gastrointestinal tract, and the imaging unit is an endoscope.
Also, an in vivo monitoring method is provided, and includes a step of sequentially creating an object image with expression of a surface color of an object in a body cavity. A specific area is determined within the object image, the specific area being movable by following motion of the object. A monitor image including change information of oxygen saturation is generated according to apart image included in the object image and located in the specific area. The monitor image is displayed.
Furthermore, a location of the specific area is updated according to the motion of the object at each time of creating a frame of the object image. The oxygen saturation of the part image in the specific area is acquired when the specific area is updated. The monitor image includes a graph of the oxygen saturation changeable with time.
In the acquiring step, the oxygen saturation of the specific area is acquired according to two spectral data with respect to wavelengths of which an absorption coefficient is different between oxidized hemoglobin and reduced hemoglobin in data of the object image.
Also, a user interface for tissue imaging is provided, and includes an imaging region for sequentially creating an object image with expression of a surface color of an object in a body cavity. A specific area is determined within the object image, and movable by following motion of the object. A generating region is for generating a monitor image including change information of oxygen saturation according to a part image included in the object image and located in the specific area. A displaying region is for displaying the monitor image.
Also, a computer executable program for tissue imaging is provided, and includes an imaging program code for sequentially creating an object image with expression of a surface color of an object in a body cavity. A determining program code is for determining a specific area within the object image, the specific area being movable by following motion of the object. A generating program code is for generating a monitor image including change information of oxygen saturation according to a part image included in the object image and located in the specific area. A displaying program code is for displaying the monitor image.
Consequently, oxygen saturation of body tissue in a body cavity is monitored with high stability even upon incidental shift of a field of view of an imaging instrument for imaging of by body tissue, because a lock area of an object image is utilized to follow the motion of an object of interest.
The above objects and advantages of the present invention will become more apparent from the following detailed description when read in connection with the accompanying drawings, in which:
In
Trocars 17 and 18 guide the electrocautery device 5 and the laparoscope 12 for entry in the body cavity. The trocar 17 includes a trocar sleeve 17a of metal and a manually operable trocar housing 17b. The trocar 18 includes a trocar sleeve 18a of metal and a manually operable trocar housing 18b. A doctor or operator percutaneously enters tips of the trocar sleeves 17a and 18a into a body by grasping the trocar housings 17b and 18b, so as to advance the trocar sleeves 17a and 18a into the body. The electrocautery device 5 and the laparoscope 12 are entered into the body through the trocars 17 and 18 while guided by the trocar sleeves 17a and 18a.
The laparoscope system 2 operates in plural modes including a normal imaging mode and a monitor mode. In the normal imaging mode, the display panel 14 displays a normal image of an object with visible light of wavelengths from blue to red. In the monitor mode, oxygen saturation of body tissue is monitored with time, the body tissue including blood vessels, which are medically important for artery bypass operation or the like. The laparoscope 12 includes a selection switch 23. The modes are selectively set in response to a control signal generated by the selection switch 23 or an input interface 15 connected externally.
In
Condenser lenses (not shown) condense light from the laser light sources LD1 and LD2. There are fiber optics 24 and 25 upon which the condensed light is incident. Examples of the laser light sources LD1 and LD2 include InGaN laser diodes of a broad area type, InGaNAs laser diodes, GaNAs laser diodes and the like.
The lighting control unit 20 controls the laser light sources LD1 and LD2 to adjust their emission sequence and a ratio between their light amounts. In the normal imaging mode of the embodiment, the laser light source LD1 is turned off. The laser light source LD2 is turned on. In the monitor mode, only the laser light source LD1 is turned on while the laser light source LD2 is turned off. Otherwise, only the laser light source LD2 is turned on while the laser light source LD1 is turned off. The operation of their changeover is repeated at each time of a lapse of a predetermined time.
The optical coupler 21 combines light from the fiber optics 24 and 25. The combined light is distributed by the optical distributor 22 to generate light of four light paths. Among those, the light from the laser light source LD1 is transmitted by light guide devices 26 and 27. The light from the laser light source LD2 is transmitted by light guide devices 28 and 29. An example of each of the light guide devices 26-29 is a bundle fiber including a great number of optical fibers. It is possible to introduce the light from the laser light sources LD1 and LD2 directly to the light guide devices 26-29 without use of the optical coupler 21 or the optical distributor 22.
The laparoscope 12 includes a guide tube 32 with a head assembly for imaging, a light emitter 33, an imaging unit 34 or camera head, a handle device 35 and a connector 36. The light emitter 33 emits light from the four light paths in association with the light guide devices 26-29. The imaging unit 34 as a single unit detects object light from an object for imaging. The handle device 35 is manually held, and used for steering of the head assembly of the guide tube 32 and for imaging. The connector 36 connects the guide tube 32 and the illumination apparatus 11 to the processing apparatus 13 in a removable manner.
Two lighting windows 43 and 44 are formed in the light emitter 33 and disposed beside the imaging unit 34, and apply measuring light and white light to an object of interest. An imaging window 42 is formed in the imaging unit 34 at the center of the tip of the guide tube 32, and receives light reflected by the object of interest for imaging.
Two lighting units 46 and 47 are contained in a space behind the lighting window 43. A lens 48 is associated with the lighting unit 46, which emits measuring light from the light guide device 26 through the lens 48 toward an object of interest. Also, a lens 51 is associated with the lighting unit 47, which emits white light created by the phosphor 50 and the light guide device 28, and applies the white light through the lens 51 toward the object of interest. Additionally, two lighting units 53 and 54 are contained in a space behind the lighting window 44. The lighting unit 53 is similar to the lighting unit 46. The lighting unit 54 is similar to the lighting unit 47.
The lighting units 46, 47, 53 and 54 are arranged in the manner of
The phosphor 50 excites to emit light from green to yellow by partially absorbing excitation light from the laser light source LD2. Examples of compounds included in the phosphor 50 are YAG phosphor, BAM phosphor (BaMgAl10O17) and the like. When the excitation light becomes incident upon the phosphor 50, the phosphor 50 applies composite light to body tissue of a body cavity, the composite light being broad band light (pseudo white light) in combination of the fluorescence from green to yellow from the phosphor 50, and the excitation light transmitted by the phosphor 50. An example of the phosphor 50 is Micro White (MW) (trade name) manufactured by Nichia Corporation.
In
Note that the white light as broad band light for a technical term in the present invention not only is white light broadly containing all components of visible light, but also can be the pseudo white light described above, light at least containing red, green and blue components as primary colors, and also light containing components from green to red, and light containing components from blue to green.
Plural elements are disposed behind the imaging window 42, including a lens system and an image sensor 60. The lens system (not shown) receives object light from an object. The image sensor 60, for example, CCD (charge coupled device) and CMOS (complementary metal oxide semiconductor), detects the object light for imaging the object.
The image sensor 60 receives light from the lens on its reception surface, and converts the light photoelectrically into a video signal of analog signal. The image sensor 60 is a color CCD and has plural arrays of pixels, namely red pixels of red filters, green pixels of green filters, and blue pixels of blue filters.
In
A signal line 67 transmits the video signal (analog) from the image sensor 60. An A/D converter 68 is supplied with the video signal by the signal line 67. The A/D converter 68 converts the video signal into an image signal in a digital form which corresponds to the voltage level of the video signal before the conversion. A normal image generator 80 for a normal image and a monitor controller 82 for oxygen saturation or oxygen saturation monitoring unit are incorporated in the processing apparatus 13, and supplied with the image signal through the connector 36.
An imaging control unit 70 controls imaging of the image sensor 60. In
In
Let B1 be a blue signal output by blue pixels of the image sensor 60 in relation to an image signal of a first frame of a special light mode image. Let G1 and R1 be green and red signals output by green and red pixels of the image sensor 60 in relation to the image signal of the first frame of the special light mode image. Let B2 be a blue signal output by blue pixels of the image sensor 60 in relation to an image signal of a second frame of a special light mode image. Let G2 and R2 be green and red signals output by green and red pixels of the image sensor 60 in relation to the image signal of the second frame of the special light mode image.
In
The normal image generator 80 creates a normal image by image processing of an image signal obtained in the normal imaging mode. The normal image is displayed on the display panel 14.
In the monitor mode, the monitor controller 82 measures changes in the oxygen saturation with time for an object of interest in a body cavity, and monitors a state of oxygen in the object of interest. In
The image input unit 85 receives an evaluation image set in an order of imaging with the image sensor 60, and sends data of the evaluation image set to the monitor image generating unit 86, the area determining unit 87 and the location updating unit 90. In
In
After the lock area 98 is determined, image sets are sent to the image acquisition unit 88, including the first evaluation image set (first normal image and first special light mode image), and the second evaluation image set (second normal image and second special light mode image), . . . , and the nth evaluation image set (nth normal image and nth special light mode image). The number n is an integer of 2 or more, and expresses that its time point of imaging is late according to its increase.
In
Note that the numeral of 100 in
Also, the image acquisition unit 88 extracts signal levels (blue signal B1′, green signal G1′ and red signal R1′) of the part image of the lock area 98 from the special light mode image in the evaluation image set, and extracts signal levels (blue signal B2′, green signal G2′ and red signal R2′) of the part image of the lock area 98 from the normal image. The extracted signal levels are used for determining oxygen saturation of the body tissue.
In
The correlation memory 89b stores information of a correlation between the oxygen saturation and signal ratios B1/G2 and R2/G2 of the total of the image signal obtained in the monitor mode for oxygen saturation. The correlation is expressed by use of a two-dimensional table of
The above correlation is relevant closely to characteristics of absorption and light scattering of oxidized hemoglobin and reduced hemoglobin, as illustrated in
The absorption coefficient of blood hemoglobin has dependency to the wavelength of light, specifically as follows.
If the wavelength is in a range of 470 nm plus or minus 10 nm (near to 470 nm as center wavelength of blue), the absorption coefficient is changeable greatly according to a change in the oxygen saturation.
If the wavelength is in a range of 540-580 nm of green, the absorption coefficient is not remarkably influenced by the oxygen saturation.
Also, if the wavelength is in a range of 590-700 nm of red, the absorption coefficient is not influenced by the oxygen saturation, because the absorption coefficient is extremely small.
The arithmetic processor 89c determines oxygen saturation in the lock area 98 by use of the correlation read from the correlation memory 89b and the signal ratios B1′/G2′ and R2′/G2′ obtained by the ratio generator 89a. To this end, at first a coordinate point P corresponding to the signal ratios B1′/G2′ and R2′/G2′ is determined in a two-dimensional space in
In the drawing, a lower limit 105 is a curve where the oxygen saturation is 0%. An upper limit 106 is a curve where the oxygen saturation is 100%. If the coordinate point P is located between the upper and lower limits 105 and 106, one of the isolines where the coordinate point P is located is specified to read oxygen saturation associated with the isoline. For example, the coordinate point P in
The coordinate point P may not be present between the upper and lower limits 105 and 106. If the coordinate point P is located higher than the lower limit 105, then the oxygen saturation is set equal to 0%. If the coordinate point P is located lower than the upper limit 106, then the oxygen saturation is set equal to 100%. Note that if the coordinate point P is not present between the upper and lower limits 105 and 106, it is possible to hide the coordinate point P due to unreliability of oxygen saturation of pixels.
In
In
The operation of the embodiment is described now by referring to the flow chart in
At each time of creating an evaluation image set, the display panel 14 displays the monitor image 94 for in vivo monitoring. In the monitor image 94, the object image 92 appears as a normal image in the evaluation image set. The graph 93 beside the object image 92 expresses the oxygen saturation of the body tissue in a time sequential manner. While the monitor image 94 is displayed, the reference area 96 is indicated in the object image 92 before setting the lock area 98.
A doctor or operator observes the image on the display panel 14, and manipulates the input interface 15 and the head assembly of the guide tube 32 to place an object of interest of the body tissue in the reference area 96. He or she depresses the lock-on switch 19 when the object of interest enters the reference area 96. Thus, a region of the object of interest is determined as the lock area 98. Operation of the lock-on starts.
When the lock area 98 is set, the landmark points 100 are extracted from the first normal image of the first evaluation image set at the time of setting the lock area 98. Also, signal levels B1′, G1′ and R1′ of the part image of the lock area 98 are extracted from the first special light mode image of the first evaluation image set. Signal levels B2′, G2′ and R2′ of the part image of the lock area 98 are extracted from the first normal image.
When a signal level of the part image of the lock area 98 is determined, then the signal ratios B1′/G2′ and R2′/G2′ of the part image are determined by the ratio generator 89a. Then the arithmetic processor 89c obtains an oxygen saturation corresponding to the signal ratios B1′/G2′ and R2′/G2′ on the basis of the correlation stored in the correlation memory 89b. Thus, the oxygen saturation of the lock area 98 is acquired. The acquired oxygen saturation is plotted on the object image 92 in the monitor image 94 by the graph generator 86a.
Then plural landmark points are extracted from second normal image in a second evaluation image set created after the first evaluation image set. Landmark points, which are included in those in the second normal image and those in the first normal image and of which the feature value is equal, are specified. A movement amount M between the specified landmark points is obtained. A shift between the first and second normal images is obtained according to the movement amount M, so as to update the location of the lock area 98. An oxygen saturation of the part image of the lock area 98 of the updated location is measured, and plotted on the graph 93, in the manner similar to that described above.
For third, fourth, . . . , and nth evaluation image sets, the lock area 98 is updated similarly. The oxygen saturation is measured and plotted in the graph 93. The measurement and plotting of the oxygen saturation are repeated until the lock-on switch 19 is depressed next. Thus, the lock area 98 is displaced according to motion of the object of interest. The oxygen saturation of the lock area 98 is determined at each time of the motion. If there is a large shift in the object of interest, the change with time can be monitored for the oxygen saturation of the object of interest.
When the lock-on switch 19 is depressed again, the locked state is terminated for release. The measurement of the oxygen saturation of the lock area 98 is terminated. At the same time, the lock area 98 is deleted in the object image 92. The reference area 96 is displayed in the object image 92 again.
In
The laparoscope system 120 includes a white light source 121 or broad band light source, the filter wheel 122, fiber optics 123 and a rotation control unit 124 in place of the laser light sources LD1 and LD2, the lighting control unit 20 and the optical coupler 21. The white light source 121, for example, a xenon light source, emits white light of spectral intensity of
In
The white light according to the embodiment has spectral distribution of
In
When the filter wheel 130 is used, the image sensor 60 of a monochromatic type detects object light for imaging at each time that the first, second and third light components are transmitted and applied to the object. Thus, image signals of three frames are obtained in a condition with the first, second and third light components. Let a blue signal B be an image signal obtained after lighting with the first light component. Let a green signal G be an image signal obtained after lighting with the second light component. Let a red signal R be an image signal obtained after lighting with the third light component. Signal ratios for determining oxygen saturation are B/G and RIG. The ratio RIG corresponds to the ratio R2/G2 of the first embodiment. The ratio B/G corresponds to the ratio B1/G2 of the first embodiment.
In the above embodiment, the medical instrument for use in the imaging system of the invention is the laparoscope. Furthermore,
The endoscope system 200 includes an illumination apparatus 201, a processing apparatus 203, and a display panel 204 as display unit in the same manner as those in the laparoscope system 2. A gastrointestinal endoscope 202 includes an elongated tube 206 or guide tube, a head assembly 206a, four lighting units and an imaging unit. The lighting units apply measuring light and white light to a wall of a body cavity in the manner of the light emitter 33. The imaging unit images the wall of the body cavity in the manner of the imaging unit 34. Remaining portions of the endoscope 202 are constructed in the manner of the laparoscope 12.
Steering wheels 212 are rotatable for steering the head assembly 206a of the elongated tube 206 up and down and to the right and left. It is likely that a doctor or operator visually misses an object of interest when the head assembly 206a is steered. However, the lock area 98 is used for marking the object of interest as described heretofore, so that the object of interest will not be missed. Measurement of the oxygen content of the object of interest can be reliable in use of the endoscope 202.
In the above embodiments, the lock area is updated by use of the landmark points obtained by the edge detection. However, other parameters may be used for updating the lock area, for example, width, depth and shape of blood vessels.
Although the present invention has been fully described by way of the preferred embodiments thereof with reference to the accompanying drawings, various changes and modifications will be apparent to those having skill in this field. Therefore, unless otherwise these changes and modifications depart from the scope of the present invention, they should be construed as included therein.
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